A new protection in the No Surprises Act will ban “surprise” balance billing beginning on or after January 1st, 2022. On average, 18% of emergency department visits result in at least one surprise bill, but the rate varies by state.
For a deeper dive into how the No Surprises Act will affect employers and brokers, we sat down with Mployer Advisor Founder and CEO Brian Freeman.
Q: Why is the No Surprises Act an important topic for insurance brokers and employers in the insurance industry today?
BF: Good question. The No Surprises Act is some of the most meaningful legislation that has been passed in the last decade to protect employers. This will save employees on employer-sponsored health care over $20 billion a year.
Q: The No Surprises Act takes effect on January 1, 2022. What should employers expect to receive from their brokers?
BF: There are two main segments of the No Surprises Act. The first is the elimination of out-of-network charges for employees. Every employer should communicate to their employees details about what will no longer be required for out-of-network bills under specific circumstances. The second are the Additional Fee Disclosures. More will come over the next 90 days, but that should be a win for employers, top brokers and the industry in general.
Q: What about on the broker side? How should brokers assess their readiness?
BF: The biggest change for brokers is the Additional Fee Disclosures. That legislation is still evolving, but it will take effect January 1st, 2022. More than likely, this will mirror a lot of the disclosures that are currently required in the 401(k) space. So one: Brokers need to understand what the changes are and what the final outcome will be. And two: How should brokers communicate those changes to their employer customers?
Q: Do you have any predictions about how the No Surprises Act could change practices in states with existing balance billing protections?
BF: States had to start implementing their own laws, because there was nothing from a federal perspective protecting the state. So, each state took it upon themselves to start building up their own. Now, there will be a federal law that should protect everyone. States can enact additional legislation on top of that to offer further protections, but there will finally be a baseline protection for all employers and employees.
Q: Do you have any examples of what protections look like in those states?
BF: Currently, I think about 20 of the 50 states have some form of balance billing protection. Some of those are specific to air ambulances, helicopters and so on.
Q: Do you think the No Surprises Act represents an important shift in the industry?
BF: Yes, absolutely–both for the elimination of out-of-network billing, as well as for broker fee disclosure. This legislation empowers the employer and the patient; in fact, this act grants them more power than they’ve ever had in the history of U.S. healthcare. This moment marks a great step forward for transparency and for the industry.
Q: Is there anything else about the No Surprises Act, for either employers or brokers, that you think is important to mention that we haven't yet discussed?
BF: A lot of people put a lot of time and effort into this cause over the past 10 years, from local legislators to prominent figures like Dr. Marty Makary. The No Surprises Act marks a big win for employers and employees, and I believe this moment should be communicated and celebrated.
To learn more about the No Surprises Act, check out Mployer Advisor’s latest webinar the “No Surprises Act: Employee Impact & Broker Fee Disclosure.” Click here to view this free, on-demand webinar featuring Mployer Advisor CEO & Founder Brian Freeman and James Bristol and Sarah Hooper of Waller, a Nashville, Tennessee-based law firm.
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